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NPI Code Detail

MEDICARE: MRS. NANCY JEAN LOPEZ P.T.

MEDICARE: MRS. NANCY JEAN LOPEZ P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT 20763CA

General Provider Information

NPI Number : 1831353143
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. NANCY JEAN LOPEZ P.T.
Provider Business Mailing Address
First Line : 22340 HARBOR RIDGE LN
Second Line : #2
City : TORRANCE
State : CA
Zip : 90502-2435
Country : US
Telephone Number : 310-320-9002
Fax Number :
Provider Business Practice Location Address
First Line : 1919 S CATALINA AVE
Second Line :
City : REDONDO BEACH
State : CA
Zip : 90277-5515
Country : US
Telephone Number : 310-378-7246
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2008
Last Update Date : 07/16/2008

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